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Muscle Nerve. 2016 Nov;54(5):967-969. doi: 10.1002/mus.25274. Epub 2016 Aug 17.

Association between glycemic variability and peripheral nerve dysfunction in type 1 diabetes.

Author information

1
Prince of Wales Clinical School, University of New South Wales Australia, NSW 2052, Sydney, Australia.
2
School of Medical Sciences, University of New South Wales Australia, Sydney, Australia.
3
Department of Endocrinology, Prince of Wales Hospital, Sydney.
4
Prince of Wales Clinical School, University of New South Wales Australia, NSW 2052, Sydney, Australia. arun.krishnan@unsw.edu.au.

Abstract

INTRODUCTION:

Glycemic variability (GV) may be a novel factor in the pathogenesis of diabetic complications. However, the effect of GV on peripheral nerve function has not been explored systematically.

METHODS:

The relationship between GV and acute glucose levels on motor and sensory nerve function in 17 patients with type 1 diabetes mellitus (T1DM) was assessed using continuous glucose monitoring and nerve excitability techniques to provide insight into the behavior of axonal voltage-gated ion channels. The mean amplitude of glycemic excursions (MAGE) was calculated to quantify GV.

RESULTS:

MAGE strongly correlated with excitability markers of altered motor and sensory axonal function, including superexcitability (r = 0.54), S2 accommodation (r = -0.76), minimum current threshold (I/V) slope (r = 0.71), strength duration time constant (r = 0.66), and latency (r = 0.65; P <  0.05). Acute glucose levels did not correlate with markers of axonal function.

CONCLUSIONS:

These findings suggest that GV may be an important mediator of axonal dysfunction in T1DM and a contributing factor in development of diabetic neuropathy. Muscle Nerve, 2016 Muscle Nerve 54: 967-969, 2016.

KEYWORDS:

continuous glucose monitoring; diabetic neuropathy; glycemic variability; nerve excitability; type 1 diabetes mellitus

PMID:
27465125
DOI:
10.1002/mus.25274
[Indexed for MEDLINE]

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